Scott Allen Cooper, PA-C
Physician Assistant, Medical in Ardmore, OK. Individual provider (NPI-1).
NPI number1427335348
StatusActive
Last updated in NPPESOct 28, 2024
Details
- NPI
- 1427335348
- Entity type
- Individual (NPI-1)
- Name
- Mr. Scott Allen Cooper
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 6, 2011
- Certification date
- Oct 22, 2024
- Last updated
- Oct 28, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | 2044 | OK | Yes |
| 363AM0700X | Physician Assistant, Medical | 60779055 | WA | |
| 363AM0700X | Physician Assistant, Medical | 55258 | CA | |
| 363AM0700X | Physician Assistant, Medical | MED-PAC-LIC-60682 | MT | |
| 363AM0700X | Physician Assistant, Medical | 126935 | AK | |
| 363AM0700X | Physician Assistant, Medical | PA-1286 | AR |
Practice location
1420 12th Ave NwArdmore, OK 73401
Phone 580-798-4122 · Fax 580-405-2048
Mailing address
1420 12th Ave NwArdmore, OK 73401
Phone 580-798-4122 · Fax 580-405-2048
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All 10 Medical Physician Assistant providers in Ardmore · All 1,684 providers in Ardmore
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